Multimodality Imaging in Sarcomeric Hypertrophic Cardiomyopathy: Get It Right horizontal ellipsis on Time

Hypertrophic cardiomyopathy (HCM) follows highly variable paradigms and disease-specific patterns of progression towards heart failure, arrhythmias and sudden cardiac death. Therefore, a generalized standard approach, shared with other cardiomyopathies, can be misleading in this setting. A multimodality imaging approach facilitates differential diagnosis of phenocopies and improves clinical and therapeutic management of the disease. However, only a profound knowledge of the progression patterns, including clinical features and imaging data, enables an appropriate use of all these resources in clinical practice. Combinations of various imaging tools and novel techniques of artificial intelligence have a potentially relevant role in diagnosis, clinical management and definition of prognosis. Nonetheless, several barriers persist such as unclear appropriate timing of imaging or universal standardization of measures and normal reference limits. This review provides an overview of the current knowledge on multimodality imaging and potentialities of novel tools, including artificial intelligence, in the management of patients with sarcomeric HCM, highlighting the importance of specific red alerts to understand the phenotype-genotype linkage.

Automated summary

Hypertrophic cardiomyopathy (HCM) has highly variable progression patterns and disease-specific features. A multimodality imaging approach and artificial intelligence techniques can assist in diagnosis and management. However, barriers such as timing of imaging and standardization of measures persist. This review highlights the importance of understanding the phenotype-genotype linkage in HCM and the potential of novel imaging tools and artificial intelligence.